目的:探讨巨刺电针治疗人工全膝关节置换术(TKA)后疼痛的临床疗效.方法:将70例全膝关节置换术患者根据统计软件产生的随机数字分为巨刺电针组和假电针组,每组各35例.分别予以巨刺电针及假电针从术后第3天开始干预,连续治疗5 d,1次/d,每周治疗5 d,连续治疗2周.治疗穴位为对侧的伏兔、足三里、阴陵泉和阳陵泉.分别记录治疗前后患者视觉模拟量表(VAS)评分、压力痛阈值(PPT)、美国膝关节协会评分(American Knee Society Score,AKSS)、抑郁自评量表(Self-rating Depression Scale,SDS)评分和焦虑自评量表(Self-rating Anxiety Scale,SAS)评分、额外镇痛药物使用次数和不良事件的发生情况.结果:本试验共纳入70例患者,其中巨刺电针组脱落2例,假电针组脱落3例.两组患者的基线资料比较,差异均无统计学意义(P＞0.05);与同组治疗前比较,两组患者术后第7天和第14天的VAS评分均降低,差异有统计学意义(P＜0.05),PPT值均升高,差异有统计学意义(P＜0.05).与假电针组同期比较,巨刺电针组VAS评分降低更明显,差异有统计学意义(P＜0.05);PPT值增高明显,差异有统计学意义(P＜0.05).治疗前两组患者AKSS、SDS和SAS评分相比,差异无统计学意义(P＞0.05);与同组治疗前比较,两组患者治疗后的AKSS均增高,差异有统计学意义(P＜0.05);SDS和SAS评分均降低,差异有统计学意义(P＜0.05).与假电针组治疗后比较,巨刺电针组AKSS增高更明显,差异有统计学意义(P＜0.05);SDS和SAS评分降低明显,差异有统计学意义(P＜0.05).巨刺电针组使用镇痛药物的次数少于假电针组,差异有统计学意义(P＜0.05).临床研究期间两组患者均无不良事件发生.结论:巨刺电针能降低患者全膝关节置换术后的疼痛强度,促进膝关节功能恢复,改善患者不良情绪.
Clinical Observation on the Therapeutic Effect of Opposing Side Electroacupuncture on Postoperative Pain after Artificial Total Knee Arthroplasty
Objective:To explore the clinical efficacy of opposing side electroacupuncture in the treatment of pain after total knee arthroplasty(TKA).Methods:70 TKA patients were randomly divided into opposing side electroacupuncture group and sham electroacupuncture group based on statistical software,with 35 cases in each group.Interventions were given with opposing side electroacupuncture and sham electroacupuncture starting from the third day after surgery,with contin-uous treatment for 5 d,once a day,5 d a week,for 2 weeks.The therapeutic acupoints are located on the opposite side of Futu(ST32),Zusanli(ST36),Yinlingquan(SP9),Yanglingquan(GB34).Record the patient's visual analogue scale(VAS)scores,pressure pain threshold(PPT),American Knee Society Score(AKSS),self-rating depression scale(SDS)scores,self-rating anxiety scale(SAS)scores,number of additional analgesics,and incidence of adverse events before and after treatment.Results:A total of 70 patients were included in this trial,including 2 cases in the opposing side electroacu-puncture group and 3 cases in the sham electroacupuncture group.There was no statistically significant difference in base-line data between the two groups of patients(P＞0.05).Compared with before treatment in the same group,the VAS scores of both groups of patients decreased(P＜0.05)and the PPT values increased(P＜0.05)at 7 and 14 d after sur-gery.Compared with the sham electroacupuncture group during the same period,the VAS scores of the opposing side elec-troacupuncture group decreased more significantly(P＜0.05),and the PPT value increased significantly(P＜0.05).There was no statistically significant difference in AKSS,SDS,and SAS scores between the two groups of patients before treatment(P＞0.05).Compared with before treatment in the same group,the AKSS of both groups of patients increased after treatment(P＜0.05),while the SDS and SAS scores decreased(P＜0.05).Compared with the sham electroacupunc-ture group,the opposing side electroacupuncture group showed a more significant increase in AKSS(P＜0.05),while SDS and SAS scores decreased significantly(P＜0.05).The number of times analgesic drugs were used in the opposing side electroacupuncture group was lower than that in the sham electroacupuncture group,and the difference was statistically significant(P＜0.05).During the clinical study,neither group of patients had any adverse events.Conclusion:Opposing side electroacupuncture can reduce the pain intensity of patients after TKA surgery,promote knee joint function recovery,and improve their negative emotions.
opposing side electroacupuncturetotal knee arthroplastyknee osteoarthritispostoperative painanalgesia
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